A physician's usage of the typical otoscope to perform a diagnostic inspection of a patient's tympanic membrane can be frustrated due to a variety of causes. These include narrow ear canals, excess cerumen and hair that can block the physician's view of the tympanic membrane. With many children, as with some adults, the prospect of the physician forcibly invading the patient's personal space as well as the external auditory canal is very disconcerting to the patient. This apprehension can cause seriously disruptive behavior, especially in child patients. It is additionally traumatizing, both physically and emotionally, to small children (and some adults) to have to blindly scrape cerumen out of their external auditory canals in order to simply inspect the ear canal and tympanum. Cerumen serves a purpose and unless it is causing diminished hearing it should be left alone.
The field has recognized these problems and has been motivated to seek solutions. For example, Krug et al. (U.S. Pat. No. 5,209,757) disclose an illuminated ear cleaning device. The Krug device comprises a small lamp in proximity with retrieval tool (ear wax loop) at the end of a probe. The lamp illuminates the point of use and a magnifying lens provided at the base of the probe is focused at the point of use to improve viewing the site. However, the Krug device requires that a user be in very close proximity of the patient being examined. Elliott (U.S. Pat. No. 6,416,464) discloses an effort to provide a variety of attachments for use with an existing otoscope. The Elliott attachments provide a variety of means for inspecting an ear or a nose and removing foreign material therefrom. The Elliott device, like the Krug device, requires that a user be in very close proximity of the patient being examined. Unlike the Krug device, the Elliot system does not provide a source of illumination proximate the site under examination.
Recently, Koda (U.S. Pat. No. 6,699,178) disclosed a self-contained endoscopic auditory canal cleaning apparatus. The Koda apparatus is self-contained in that it included an active electrical power supply and associated circuits. The Koda apparatus comprises an internally illuminated ear-pick made of a light passing material and held in a hollow holding part. The ear-pick and hollow holding part combination is rotatable around a separate fiberscope imaging cable. Diffused light emitted from the ear-pick is used to illuminate the auditory canal and the fiberscope is used to capture images and send them to a display device. The display device has an eyepiece part and a main body. The eyepiece part comprises a simple convex lens to match the fiberscope to the eyepiece part. The display device also comprises a battery power supply and associated light source circuitry.
Although the above devices and other in the field may be useful for their intended purposes, it would still be beneficial to the field to have an alternative otoscope that can directly illuminate and image the tympanum without violating a patient's comfort zone. It would also be beneficial if the device could easily be adapted to remove material or foreign objects from the auditory canal as well. It would be additionally beneficial if the otoscope was passive, in that it contained no para-magnetic and generated no electric fields, allowing it to be used in otherwise restrictive environments (e.g., in proximity to an MRI machine or in an oxygen rich atmosphere). It would be further beneficial to have such a fiberoptic otoscope device that directly interfaced with existing light sources, such as the Welch Allyn otoscope handle.